A nurse in the Emergency Department is evaluating a patient’s cardiac rhythm. What is the correct interpretation of the rhythm and the appropriate treatment?

Choice A rationale
While it’s important to inquire about an allergy to iodine in a patient who has undergone an angiogram, it’s not typically the priority for assessing and documenting for this patient after the procedure. An allergy to iodine would be more relevant before the procedure, as iodine-based contrast dye is often used during an angiogram.
Choice B rationale
Checking peripheral pulses in the affected leg is typically a priority when caring for a patient who has undergone an angiogram. This is because the procedure involves inserting a catheter into a blood vessel in the leg. Checking the peripheral pulses can help assess for potential complications such as a blood clot or decreased blood flow to the leg.
Choice C rationale
Monitoring for decreased blood pressure is important in a patient who has undergone an angiogram, but it’s not typically the priority for assessing and documenting for this patient after the procedure. While changes in blood pressure can occur after any medical procedure, other assessments such as checking peripheral pulses in the affected leg are typically more directly related to potential complications of an angiogram.
Choice D rationale
Tracking fluid intake is an important part of overall patient care, but it’s not typically the priority for assessing and documenting for a patient who has undergone an angiogram. Other assessments such as checking peripheral pulses in the affected leg are typically more directly related to potential complications of an angiogram.

The correct answer is Choice D.

Choice A rationale: Allergies to shellfish may indicate iodine allergy, relevant for procedures using iodine-based contrast, like PCI. The client’s shellfish allergy must be reported to the PHCP as a precautionary measure to prevent any allergic reaction.

Choice B rationale: Warm sensations during PCI are a common side effect of the contrast dye used in the procedure. This statement does not indicate an immediate concern requiring PHCP notification as it is a standard patient experience.

Choice C rationale: Anxiety in closed spaces, known as claustrophobia, may affect the client's comfort during PCI but can be managed with sedatives. The PHCP should be aware but it’s not as urgent as taking contraindicated medications.

Choice D rationale: Metformin can lead to lactic acidosis, especially when iodine contrast dye is used during PCI. This condition is serious and may result in adverse interactions. The PHCP must be notified immediately.